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  4. Importance of the subscapularis muscle after total shoulder arthroplasty
 
research article

Importance of the subscapularis muscle after total shoulder arthroplasty

Terrier, Alexandre  
•
Larrea, Xabier  
•
Malfroy Camine, Valérie  
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2013
Clinical Biomechanics

Background: The rotator cuff muscles are the main stabilizer of the glenohumeral joint. After total shoulder arthroplasty using anterior approaches, a dysfunction of the subscapularis muscle has been reported. In the present paper we tested the hypothesis that a deficient subscapularis following total shoulder arthroplasty can induce joint instability. Methods: To test this hypothesis we have developed an EMG-driven musculoskeletal model of the glenohumeral joint. The model was based on an algorithm that minimizes the difference between measured and predicted muscular activities, while satisfying the mechanical equilibrium of the glenohumeral joint. A movement of abduction in the scapular plane was simulated. We compared a normal and deficient subscapularis. Muscle forces, joint force, contact pattern and humeral head translation were evaluated. Findings: To satisfy the mechanical equilibrium, a deficient subscapularis induced a decrease of the force of the infraspinatus muscle. This force decrease was balanced by an increase of the supraspinatus and middle deltoid. As a consequence, the deficient subscapularis induced an upward migration of the humeral head, an eccentric contact pattern and higher stress within the cement. Interpretation: These results confirm the importance of the suscapularis for the long-term stability of total shoulder arthroplasty.

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Type
research article
DOI
10.1016/j.clinbiomech.2012.11.010
Web of Science ID

WOS:000318322600006

Author(s)
Terrier, Alexandre  
Larrea, Xabier  
Malfroy Camine, Valérie  
Pioletti, Dominique  
Farron, Alain  
Date Issued

2013

Publisher

Elsevier Sci Ltd

Published in
Clinical Biomechanics
Volume

28

Start page

146

End page

150

Subjects

shoulder

•

rotator cuff muscles

•

arthroplasty

•

musculoskeletal model

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LBO  
Available on Infoscience
April 9, 2013
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/91364
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